Histopathological analysis of hysterectomy specimens

Background: Uterus is prone for various non-neoplastic and neoplastic lesions and also hysterectomy is the most common gynecological surgery indicated as a definitive treatment. Grossly unremarkable many specimens may reveal pathologies on histological examination. Hence, all hysterectomy specimens must undergo proper histopathological examination. In our study, hysterectomy specimens were studied and results compared with their clinical diagnosis. Aim and Objective: The objectives of the present study were to know the frequency and incidence of various lesions of the female genital tract and to compare findings of the present study with other studies. Materials and Methods: The study was a retrospective analysis of 250 hysterectomy specimens. All types of hysterectomies such as vaginal, abdominal, laparoscopic, and total abdominal hysterectomy without or with unilateral/bilateral salpingectomy/salpingo-oophorectomy were included in the study. Histopathological examination was done minimum by two faculty members. The results were noted and statistical analysis was done. Results: Total 250 hysterectomy specimens were studied. Vaginal hysterectomy was the most commonly performed type of hysterectomy which includes 187 cases (74.8%) out of 250 cases. Among the uterine pathologies, the most common lesion was leiomyoma (34.4%) followed by adenomyosis (26%). In our study during histopathological examination of cervix, the most frequent cervical lesion was found chronic cervicitis in 50.4% of cases. Conclusion: The present study highlights the wide spectrum of lesions of female genital tract and conveys that histopathology remains the primary modality for confirmation of diagnosis of lesions. We can conclude from the present study that many lesions had been diagnosed on microscopic examination though normal gross examination. Hysterectomy specimen should undergo proper histopathological examination, because it is the gold standard tool for final diagnosis.

Iron loading anaemias.

Iron loading anaemias are characterized by anaemia, high serum iron, transferrin saturation and ferritin values, and haemosiderin deposits in parenchymal cells and reticuloendothelial tissue with or without organ dysfunction. Sideroblastic anaemias and congenital dyserythropoietic anaemias (CDA) are important types of iron loading anaemias. Two cases of sideroblastic anaemia and five cases of CDA type I are presented as prototypes of iron loading anaemias. Increased gastrointestinal absorption of iron remains the main mechanism of iron loading in these anaemias. Phlebotomy can be used to reduce the iron load in those with mild or moderate anaemia, whereas desferrioxamine can be used to chelate excessive iron in all cases irrespective of severity of anaemia.

Bone marrow iron in nutritional anaemias.

Bone marrow smears of 168 patients with nutritional anaemias attending the Dr. J.C. Patel, Department of Hematology, K.E.M. Hospital were stained by Prussian blue method for iron (haemosiderin). Iron in the bone marrow was classified as absent, decreased, normal or increased. Amongst 93 cases with transferrin saturation (TS) of less than 16% and normoblastic erythropoiesis, bone marrow iron was absent in 48 (51.6%) and decreased in 45 (48.4%). In 50 cases with TS of less than 16% and marrow showing megaloblasts and/or giant myelocytes and metamyelocytes, bone marrow iron was absent in 15 (30%), decreased in 22 (44%), normal in 7 (14%) and increased in 6 (12%). In 25 cases with TS over 16% and megaloblastic erythropoiesis, bone marrow iron was absent in 4 (16%), decreased in 1 (4%), normal in 7 (28%) and increased in 13 (52%). In 150 (89.3%) patients out of 168, bone marrow iron and TS gave concordant results whereas in 18 (10.7%), the results were discordant; former was encountered in cases of uncomplicated iron deficiency while latter was found with megaloblastic morphology of the marrow. It is concluded that there is a good correlation between TS and bone marrow iron and hence, either of the criteria can be used for the diagnosis of iron deficiency especially when it is not complicated by megaloblastosis.